Penile cancer information on the internet: a needle in a haystack

Introduction Objective Penile cancer is a disease with high morbidity and mortality and is rare in developed countries. In the developing world, the incidence is significantly higher, and accounts for 1-2% of malignant disease in men. Penile cancer is associated with delayed diagnosis, often due to psychological factors. Web based resources are especially important when obtaining information from health professionals is challenging, such as when symptoms are embarrassing or stigmatised. To assess the quality of information about penile cancer on the internet and to compare the quality of information from developed countries with developing countries. Method Results Health on the Net (HON) principles were applied to websites using the Google search engine imbedded with HON toolbar. This was used to assess 750 websites in English, French, German, Spanish and Portuguese by two independent examiners using the key word 'penile cancer' in all languages. The first 150 websites in each language were analysed. Further analysis was completed comparing results between languages and site sponsors. Of the 750 websites analysed, 10.4% were HON accredited. There were significantly more HON accredited websites in English and French compared with Portuguese (P = 0.009 and P = 0.0007). A total of 45% of websites were sponsored by Commercial enterprise and 27% were sponsored by Government organisations. Conclusion A lack of validation of penile cancer internet resources should be appreciated by clinicians. Additionally, there is a discrepancy in the quality of websites between languages, with significantly more resources available in the developed world. Limited available web resources in Spanish and Portuguese contribute to disparities in information access and disease outcomes.